The chance interaction occurred at a large medical conference I attended recently. I happened to bump into a leader in health care information technology from a major integrated medical system. As soon as I saw him and his name badge, I thought I would go over and introduce myself, seeing as I have an avid interest in health care IT myself. He was standing alone having just finished lunch, and there was a bit of free time before the next scheduled lecture.

I attempted to start a conversation, but quickly realized that this was not going to be an easy endeavor. The person initially came across as unfriendly, and then a bit awkward. I was accompanied by a couple of colleagues, and we are all reasonably jovial and cordial people who usually don't have any problems with holding a good conversation. We asked him about his thoughts on his hospital's IT system and where the world of health care IT was heading. Topics that one would expect to be of keen interest to this gentleman, given his prominent position. However, throughout the attempted conversation, he barely maintained any eye contact, seemed somewhat dismissive, and then actually started coming across as rude and derogatory when he learned that we worked in smaller community hospitals. His rudeness was quickly noted by my colleagues, 1 of whom (who is the most pleasant person you could ever meet) even went so far as to later describe him a jerk!

The interaction ended abruptly and I was left a bit speechless by the whole encounter. Here was a leader in his field, someone whose actions affect thousands at the frontlines, and he was such a poor (and to be frank, appalling) communicator. Without sounding too harsh, but in the interests of being honest, he was clearly lacking in interpersonal skills. We went on to meet other people from his organization that day, who indeed confirmed that our interaction with him was far from an outlier experience.

This got me thinking more about the types of people I've seen drawn to health care information technology over the years, and how many of them are doing it primarily as a way of getting out of clinical medicine and away from patients. Although this person was also a physician by training, the characteristics and personal traits of many doctors who would do anything to leave clinical medicine (especially right at the beginning of their careers), are often very similar.

As always, there are exceptions to any observation, and I've also met plenty of people in health care IT who are reasonably good communicators. However, this particular person I'm sure would be only too happy to sit behind a computer screen all day and have as little interaction with people as possible! As much of a computer whiz-kid as he may be, we have to ask ourselves if these are the types of leaders we really want in health care—whether they are administrators, bureaucrats or information technologists? The answer should be a resounding No. Their actions will affect far too many people, both health care professionals and patients, so they must have some sense of what health care is all about and how important good communication is.

At a time when the use of IT in healthcare has proliferated drastically—with IT systems that were unfortunately not ready for primetime and are inefficient and cumbersome to use—strategy and leadership in this field are crucial as we work towards improved software solutions that are seamless and user-friendly. Studies now show that physicians shockingly spend as little as 10% of their day in direct patient care, the majority of the rest in front of computers typing and clicking boxes.

The answer to this isn't to go back to the bad old days of pen, paper and mountains of paper charts. The answer is to simply design better IT that takes doctors and nurses back to where they should be: with their patients doing what they were trained to do.

Put quite plainly, many of those currently in the technology realm would be glad to pile more and more IT tasks onto overworked frontline clinicians, even if it meant spending 100% of their day in front of a screen. Because after all, in their world, that's what it's all about. This is why IT needs an effective and organized counterbalance from the dedicated professionals at the frontlines of medicine. In the meantime, those who are drawn into the information technology sector, must do so with a sense of the fundamental values of medicine and the correct vision of the role that IT will play in that. All leaders in health care should have a love of people and sincere desire to improve the lives of patients. Above all else, a realization that health care is about human beings and being a good real-life communicator.

Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness.
ACP Internist
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